NPIMap

Organization Active NPI

Pacifico Dental Care LLC

  • Dentist
  • Bangor, PA
National Provider Identifier
1316338205
Registry record updated Jul 26, 2016
On this page

Key facts

NPPES NPI Registry
Primary specialty
DentistTaxonomy code 122300000X
Legal business name
PACIFICO DENTAL CARE LLC
Practice address
48 N 3Rd St
Bangor, PA 18013-1908
Phone
(610) 588-2722
Fax
(610) 599-1034
NPI assigned
Feb 12, 2015
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jul 26, 2016

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name
Dr. Michael L Pacifico, DMDNPI 1669691697
Title
Owner
Phone
(610) 588-2722

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
DentistGroup: 193400000X SINGLE SPECIALTY GROUP 122300000X Primary

Addresses

Primary practice location

48 N 3Rd St
Bangor, PA 18013-1908

Mailing address

48 N 3Rd St
Bangor, PA 18013-1908
Phone (610) 588-2722

Other names 1

  • Pacifico Dental Care Doing business as

National Provider Directory

National Provider Directory

Locations

48 N 3rd St
Bangor, PA 18013
Phone (610) 588-2722

Practitioners & affiliated clinicians

Practitioners 6

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1423699200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1469491200000",
    "number": "1316338205",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "48 N 3RD ST",
            "city": "BANGOR",
            "state": "PA",
            "postal_code": "180131908",
            "telephone_number": "610-588-2722",
            "fax_number": "610-599-1034"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "48 N 3RD ST",
            "city": "BANGOR",
            "state": "PA",
            "postal_code": "180131908",
            "telephone_number": "610-588-2722",
            "fax_number": "610-599-1034"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "PACIFICO DENTAL CARE LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2015-02-12",
        "last_updated": "2016-07-26",
        "status": "A",
        "authorized_official_last_name": "PACIFICO",
        "authorized_official_first_name": "MICHAEL",
        "authorized_official_middle_name": "L",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "610-588-2722",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "DMD"
    },
    "taxonomies": [
        {
            "code": "122300000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Dentist",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Pacifico Dental Care",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Bangor, PA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 26, 2016; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.